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29 Cards in this Set

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Mgmt strategies differ for dysphagia patients with __ as opposed to ___ disorders
degenerative, sudden-onset
p. 303
What is usually significantly reduced in all neurologically impaired dysphagia patients?
Sensitivity to aspiration
p. 304
Dysphagic patients w/ stroke may exhibit reduced pharyngeal and supraglottic sensation -- T or F?
T
p. 304
In patients who fatigue easily, __may not be appropriate
Swallow maneuvers
p. 305
Why?
B/c they increase fatigue
p. 305
WHat things may be appropriate instead, w/ patients who fatigue easily (4 things)?
smaller meals, sensory stimulation, diet changes, posture changes
p. 306
In the intensive care unit, swallowing eval. should wait until __
patient is extubated
p. 306
How long may it take for pharyngeal swallow to re-start after extubation?
1 week
p. 305
WHat can be done to assess patients who are comatose?
1)Put hand on the neck and submandibular area (as described in chapter 5), hold it for 5-10 minutes to assess frequency and strength of swallow
2) use surface electromyography to do same
p. 305
What else can be done besides palpation and electromyography?
See how patient handles secretions
p. 305
If a stroke is limited to the posterior cortex (no motor function involved) will not usually develop dysphagia -- T or F?
T
p. 307
Patients w/ unilateral medullary (lower brainstem) lesions typically exhibit__
near-normal oral control, impaired trigger of pharyngeal swallow. Also, absence of pharyngeal swallow 1 week post-stroke.
p. 308
When swallow triggers, patients may exhibit __, __, and possibly __
reduced laryngeal elevation and UES opening, unilateral pharyngeal weakness, unilateral adductor paresis
p. 309
About when does swallow recover for stroke patients such that they can restart oral intake?
3 weeks post-stroke
p. 309
Patients w/ pontine (higher brainstem) stroke often experience__
hypertonicity
p. 309
Hypertonicity in these patients manifests itself as __, __, and __
delayed trigger of PS, reduced laryngeal elevation, unilateral spastic paralysis of the pharyngeal wall
p. 310
Patients w/ hypertonicity may not respond normally to head rotation -- T or F?
T
p. 310
Patients w/ hypertonicity may benefit from __
Massage to release excess muscle tone prior to swallow therapy session
p. 310
Patients w/ subcortical stroke may experience___, __, and __
delayed oral transit, delayed trigger of the PS, and neuromuscular timing impairments of pharyngeal swallow
p. 310
As a result of these impairments, these patients may exhibit __
aspiration before or after the swallow
p. 310
REcovery may take __ for these patients if there are no further complications
3-6 weeks post-stroke
p. 310
For these patients, therapy may include __ and __
improve triggering of PS, ROM motion for larynx and tongue base
p. 310
Stroke in the anterior left cortext may lead to __
apraxia of swallow
p. 310
left cortical stroke patients may also experience __, __ and __
delays in oral and pharyngeal transit, delay in PS trigger
p. 310
Patients w/ right hemisphere stroke exhibit longer __ than __
pharyngeal, oral transit delays
p. 311
Patients w/ right hemisphere stroke may benefit from __ and __
chin-down posture, thermal-tactile stim.
p. 311
They may also benefit from
airway protection thru supraglottic, super-supraglottic maneuvers; ROM exercises for laryngeal elevation
p. 311
Patients w/ right hemisphere stroke may take longer to return to oral feeding b/c __
they have cognitive disorders, inattention
p. 311
To date, no age effects have been ID'd on post-stroke recovery of swallow function -- T or F?
T
p. 313